Finding the Optimal Postnatal Dexamethasone Regimen for Preterm Infants at Risk of Bronchopulmonary Dysplasia: A Systematic Review of Placebo-Controlled Trials

PEDIATRICS ◽  
2009 ◽  
Vol 123 (1) ◽  
pp. 367-377 ◽  
Author(s):  
W. Onland ◽  
M. Offringa ◽  
A. P. De Jaegere ◽  
A. H. van Kaam
BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028066 ◽  
Author(s):  
Souvik Mitra ◽  
Timothy Disher ◽  
Gerhard Pichler ◽  
Brandon D'Souza ◽  
Helen Mccord ◽  
...  

IntroductionAs gestational age decreases, incidence of bronchopulmonary dysplasia (BPD) and chronic lung disease increases. There are many interventions used in the delivery room to prevent acute lung injury and consequently BPD in these patients. The availability of different treatment options often poses a practical challenge to the practicing neonatologist when it comes to making an evidence-based choice as the multitude of pairwise systematic reviews including Cochrane reviews that are currently available only provide a narrow perspective through head-to-head comparisons.Methods and analysisWe will conduct a systematic review of all randomised controlled trials evaluating delivery room interventions within the first golden hour after birth for prevention of BPD. The primary outcome includes BPD. Secondary outcomes include death at 36 weeks of postmenstrual age or before discharge; severe intraventricular haemorrhage (grade 3 or 4 based on the Papile criteria); any air leak syndromes (including pneumothorax or pulmonary interstitial emphysema); retinopathy of prematurity (any stage) and neurodevelopmental impairment at 18–24 months. We will search from their inception to August 2018, the following databases: Medline, EMBASE and Cochrane Central Register of Controlled Trials as well as grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information and assess the risk of bias and the confidence in the estimate (with Grading of Recommendations Assessment, Development and Evaluation approach). This review will use Bayesian network meta-analysis approach which allows the comparison of the multiple delivery room interventions for prevention of BPD. We will perform a Bayesian network meta-analysis to combine the pooled direct and indirect treatment effect estimates for each outcome, effectiveness and safety of delivery room interventions for prevention of BPD.Ethics and disseminationThe proposed protocol is a network meta-analysis, which has been registered on PROSPERO International prospective register of systematic reviews (CRD42018078648). The results will provide an evidence-based guide to choosing the right sequence of early postnatal interventions that will be associated with the least likelihood of inducing lung injury and BPD in preterm infants. Furthermore, we will identify knowledge gaps and will encourage further research for other therapeutic options. Therefore, its results will be disseminated through peer-reviewed publications and conference presentations. Due to the nature of the design, no ethics approval is necessary.


2021 ◽  
Author(s):  
Hiroki Tamon ◽  
Maiko Suto ◽  
Kunio Ogawa ◽  
Kenji Takehara ◽  
Yoshiyuki Tachibana

Abstract Background: The prevention of child abuse and neglect is an urgent matter, as abuse and neglect are associated with serious effects even into adulthood, and as there is an increased risk of the offspring of abused children being abused themselves. Intervening as early as possible may prevent abuse that can begin in infancy. Although several systematic reviews and meta-analyses have investigated the effects of interventions on populations at risk for child abuse and neglect, few studies have focused on at-risk women or interventions that start during perinatal periods. This study aims to describe a systematic review to examine the effects of interventions to prevent child abuse and neglect that begin during pregnancy and just after childbirth (less than one year). The study will involve performing a systematic review and meta-analysis based on the latest research articles up to and including November 2020 and a broader literature search.Methods: The protocol was prepared using the 2015 statement of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The review will follow Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines/statements. The literature search will be performed using the MEDLINE, PsycINFO, Embase, and Cochrane Central Register of Controlled Trials databases from inception onward. Randomized controlled trials of interventions that begin during pregnancy or the first year postpartum and are designed to prevent child abuse and neglect in at-risk families will be included. Data collection, quality assessment, and statistical syntheses will be conducted by following methods in the protocol that are defined in advance.Discussion: The findings of this systematic review and meta-analysis will be important in clinical and political settings for the prevention of child abuse and neglect. The results of this study will provide a basis for the development of evidence-based intervention programs for expectant and new parents and child abuse prevention policies. Additionally, this study will encourage future studies to conduct more evidence-based intervention programs and illuminate the direction of research on the prevention of child abuse and neglect.Systematic review registration: PROSPERO CRD42021266462


2018 ◽  
Vol 72 (4) ◽  
pp. 307-315 ◽  
Author(s):  
Karin M. Vissers ◽  
Edith J.M. Feskens ◽  
Johannes B. van Goudoever ◽  
Arieke J. Janse

Background: What is the appropriate time to start complementary feeding for preterm infants? The answer to this question is yet under debate. The timing of initiating complementary feeding may be associated with overweight in term infants. This systematic review aimed to study the effect of the timing of initiating complementary feeding on overweight in preterm infants. Predefined search items included preterm infants, complementary feeding, overweight, and their synonyms. Summary: The search identified 15,749 articles, of which 5 articles were included. Three studies presented data of randomized controlled trials and 2 studies were cohort studies. Two randomized controlled trials found no significant difference in body mass index (BMI) Z-score between the intervention groups at 12 months of age. One randomized controlled trial presented a significant greater mean rate of growth in length per week until 12 months in the preterm weaning strategy-group compared with the current best practices. One observational study concluded that each month the infants received complementary food later, the Z-score for length and weight was reduced by 0.1. Key Messages: No clear conclusion could be drawn from the included studies. This review illustrates the need for further research to access the effect of the timing of initiating complementary feeding on overweight in preterm infants.


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